Measles (rubeola)

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What is measles?

Measles, also called rubeola, is a well-known respiratory infection of childhood with cold symptoms and a characteristic rash.

Caused by a virus, measles is very easily spread from one person to another by direct body contact, or by droplets from coughing or sneezing.

The danger of spreading infection to others is highest before the rash breaks out. The time from infection until the first symptoms appear (incubation period) is about 10 days.

Measles was once among the most frequent childhood illnesses, but now is rarely seen in the U.S. because every child receives a vaccine to protect against it.

In other parts of the world, where vaccination has not been introduced and where sanitary conditions are poor, measles is a dreaded infectious disease that takes as many as one million children's lives each year.

Symptoms

Symptoms and signs

The first symptoms are high fever (as high as 105 degrees Fahrenheit or 40.6 degrees Celsius), not feeling well, irritability, tiredness, runny nose, redness of the eyes, sensitivity to light, and cough.

After a few days of these general, cold-like symptoms, bluish spots inside the mouth on the cheeks may be seen. These are called Koplik's spots.

A characteristic skin rash develops about 2 weeks after the infection, with bright red spots that are not itchy. This rash first appears on the forehead and face, and then moves down the neck and body all the way down to the legs.

The rash typically lasts 3 days on each area of the body, and usually goes away after about 1 week. The rash will often leave flaking skin that clears after a few days. 

Complications

The most common complications are diarrhea, vomiting, ear infections, febrile seizures, and pneumonia. In developing countries, the complications can lead to death from serious dehydration caused by the diarrhea.

In rare cases, meningitis and encephalitis, a serious form of brain inflammation, may occur.

Complications after the measles are more common among adults than among children.

Infection with the measles during pregnancy can lead to miscarriage or premature birth.

Home treatment

Treatment / What you should do

Contact your doctor if you suspect that your child has measles.

Antibiotics do not help against measles, because it is a viral illness. However, you should seek medical treatment if you suspect that a bacterial infection, such as ear infection or pneumonia, or other complication, has developed in addition to the measles.

You can help your child to feel more comfortable by giving fever-reducing and pain-relieving medicine, such as acetaminophen and ibuprofen, and large amounts of fluids. Never give aspirin to a child with fever, as this may trigger Reyes syndrome, a dangerous illness involving the liver and brain.

If your child seems to be getting worse during the infection, or has a rising fever, you should contact a doctor immediately.

Do not expose other children and adults to measles. If your child has measles, he or she must be kept home from school for 5 days after the rash has appeared.

Prevention

Prevention

Measles can be a serious illness and can result in serious complications.

The best way to protect your child from measles is to have him vaccinated. Routine vaccination against measles is included in the Recommended Childhood Immunization Schedule in the United States.

The measles, mumps and rubella (MMR) combination vaccine is given as a two dose series, with the first dose at age 12-15 months, and a booster dose at age 4-6 years. Ideally children get the vaccine before they are exposed to the measles virus. However, the vaccine may also be given to children who have not previously received the vaccine, and have been exposed to measles, but must be given within 3 days of the exposure.

For children who are travelling to high-risk areas in the world, the measles vaccine can be given earlier than 12 months.

The measles vaccine is made from a weakened form of the virus and must not be given to children who have problems with their immune system. It should be used cautiously in children who are allergic to eggs, as the vaccine contains egg.

Approximately 10% of children will have some fever and a slight rash 5 to 14 days after the vaccination; this is not dangerous and the child is not contagious.

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